• Title/Summary/Keyword: 심장CT

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Surgical Treatment of Pulmonary Artery Sarcoma -One case report- (급성 폐동맥 색전증으로 오인된 폐동맥 육종 -1예 보고-)

  • Park, Kuhn;Kwon, Jong-Bum;Lee, Jong-Ho;Kang, Jae-Kul;Kim, Hwan-Ook;Jo, Keon-Hyon;Wang, Young-Pil
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.597-600
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    • 2004
  • We report a rare case of pulmonary artery sarcoma mimicking pulmonary artery thromboembolism in a 57-year-old man who suffered with 2-month dyspnea and exacerbated for 1 week. He was transferred from private clinic and he was diagnosed as acute pulmonary artery thromboembolism on the basis of chest CT. Chest CT, pulmonary artery angiogram, and perfusion scan were examined. We performed surgical excision with aid of CPB. The final pathologic report was that the mass was a pulmonary artery sarcoma. We experienced one case of pulmonary artery sarcoma and reported it with reference.

Current Status and Future Perspective of Nuclear Cardiology (심장핵의학의 현황과 전망)

  • Chung, June-Key
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.159-164
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    • 2009
  • Coronary artery disease is on the rise over the world. Myocardial perfusion SPECT is a well established technique to detect coronary artery disease and to assess left ventricular function. In addition, it has the unique ability to predict the prognosis of the patients. Moreover, the application of ECC-gated images provided the quantitatve data and improved the accuracy. This approach has been proved to be cost-effective and suitable for the emerging economies as well as developed countries. However, the utilization of nuclear cardiology procedures vary widely considering the different countries and region of the world. Korea exits 2-3 times less utilization than Japan, and 20 times than the United States. Recently, with the emerging of new technology, namely cardiac CT, cardiac MR and stress echocardiography, the clinical usefulness of nuclear cardiology has been called in question and its role has been redefined. For the proper promotion of nuclear cardiology, special educations should be conducted since the nuclear cardiology has the contact points between nuclear medicine and cardiology. Several innovations are in horizon which will impact the diagnostic accuracy as well as imaging time and cost savings. Development of new tracers, gamma camera technology and hybrid systems will open the new avenue in cardiac imaging. The future of nuclear cardiology based on molecular imaging is very exciting. The newly defined biologic targets involving atherosclerosis and vascular vulnerability will allow the answers for the key clinical questions. Hybrid techniques including SPECT/CT indicate the direction in which clinical nuclear cardiology may be headed in the immediate future. To what extent nuclear cardiology will be passively absorbed by other modalities, or will actively incorporate other modalities, is up to the present and next generation of nuclear cardiologists.

Paragonimiasis with Simultaneous Multifocal Lesions (동시 다발성 폐흡충증의 임상적 치험)

  • Shin, Dong-Il;Chang, Woon-Ha;Kim, Jung-Tae;Sohn, Jin-Hee;Kim, Kyoung-Min;Oh, Tae-Yoon
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.380-383
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    • 2007
  • A 42-years-old man was referred to our department due to his hemoptysis. Chest CT showed a cavitary lung lesion in the apical segment of the RUL and an anterior mediastinal mass. The patient underwent wedge resection for the cavitary lesion and complete resection for the mediastinal mass. The pathologic finding was Paragonimus Westermani infestation in both the lung and thymus. The abdomen CT taken postoperatively showed an inflammatory mass involving the transverse colon and a small nodular lesion around the descending colon, which strongly suggested paragonimiasis. Postoperatively, the patient took Praziquantel for 2 days and he was discharged without any complications. There was no evidence of recurrence for the last 2 years.

CSF Leakage through a Subarachnoid-pleural Fistula after Resection of a Malignant Solitary Fibrous Tumor (악성 고립성 섬유종 제거술 후 발생한 뇌척수액의 흉강내로의 유출)

  • Choi, Kwang-Ho;Lee, Yang-Haeng;Hwang, Youn-Ho;Yoon, Young-Chul;Cho, Kwang-Hyun;Jung, Yong-Tae
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.332-335
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    • 2010
  • Solitary fibrous tumor is an uncommon submesothelial mesenchymal neoplasm that primarily arises from the pleura. Most solitary fibrous tumors have a benign course, and the single most important predictor of the clinical outcome is the ability to excise the entire lesion. We experienced a case of CSF leakage through a subarachnoid-pleural fistula after resection of a malignant solitary fibrous tumor and the involved rib. We detected CSF leakage via performing CT myelography and we treated this case with hemilaminectomy and dura repair.

Pulmonary Arteriovenous Fistula with Hemothorax - A case report- (혈흉을 동반한 폐동정맥루에 대한 치험 - 1예 보고 -)

  • 김인섭;정성철;김우식;신용철;유환국;김병열;안재범
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.702-706
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    • 2004
  • Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

Postintubation Tracheoesophageal Fistu1a (기관삽관후 발생한 기관식도루 -치험 1례-)

  • Jeon, Sang-Hyeop;Park, Seo-Wan;Jeong, Seong-Un;Lee, Haeng-Ryeol
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.235-238
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    • 1996
  • Acquired tracheoesophageal fistula, a life threatening lesion, is rare but occurs most frequently alter prolonged mechanical ven ilation using a cuffed endotracheal tube. The mechanism of injury seems to be ischemia and inflammation of compressed trachea and esophagus by cuffed endotracheal tube. The patient was a 25 years old pregnant woman who was on prolonged mechanical ventilation for bacterial meningitis secondary to untreated otitis media. 40 days after mechanical ventilation, sudden subcutaneous empysema and pneumomediastinum ocurred and these were due to tracheoesophageal fistula. It was diagnosed with bronchoscopy and CT We performed tracheal repair with TA 60mm stapler and esophageal repair by interruted two layer suture with 410 vicryl and 510 prolene. A flap of sternocleidomastoid muscle was inserted between trachea and esophagus. Postoperative course was uneventful and the result of operation was acceptable by esophagography.

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Traumatic Systemic Artery to Pulmonary Vessel Fistula - A case report - (외상에 의해 발생한 체동맥-폐혈관루 - 1예 보고 -)

  • Kim, Keun-Woo;Kim, Jeong-Ho;Choi, Soo-Jin;Park, Kook-Yang;Park, Chul-Hyun;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.74-78
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    • 2007
  • Systemic artery to pulmonary vessel fistula (SAPVF) is an abnormal communication between the systemic arterial circulation and the pulmonary circulation. Most SAPVF are congenital, but some SAPVF may also develop as a consequence of trauma, neoplasm, and inflammation of pleura or lung parenchyma. A 38-year-old man was referred to our department for hemoptysis. He underwent an operation for traumatic diaphragm rupture 16 years ago. Chest CT scan and angiography revealed SAPVF between several intercostal arteries and pulmonary vessels. He had an angiographic transcatheter embolization and the SAPVF disappeared at follow-up chest CT. To the best of our knowledge, this is the first case report of traumatic SAPVF in Korea.

Surgical Correction of Left Ventricular Assist Device Outflow Graft Obstruction Caused by a Wrapped Expanded Polytetrafluoroethylene Graft: A Case Report

  • Sung Min Kim;Ilkun Park;Siwon Oh;Hyo Won Seo;Ga Hee Jeong;Jun Ho Lee;Su Ryeun Chung;Kiick Sung;Wook Sung Kim;Yang Hyun Cho
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.413-417
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    • 2024
  • A 70-year-old man with dilated cardiomyopathy underwent left ventricular assist device (LVAD) implantation, using a HeartWare ventricular assist device, as a bridge to candidacy. After 26 months, computed tomography (CT) angiography indicated stenosis in the LVAD outflow graft; however, the patient was asymptomatic, prompting a decision to manage his condition with close monitoring. Ten months later, the patient presented with dizziness and low-flow alerts. Subsequent CT angiography revealed a critical obstruction involving the entire LVAD outflow graft. The patient underwent emergency surgery, during which an organized seroma causing the graft obstruction was found between a wrapped expanded polytetrafluoroethylene (ePTFE) graft and a Dacron outflow graft. The covering of the outflow graft was removed, along with the organized seroma. Following removal of the ePTFE wrap and decompression of the outflow graft, normal LVAD flow was reestablished. The practice of wrapping the outflow graft with synthetic material, commonly done to facilitate later redo sternotomy, may pose a risk for outflow graft obstruction.

Incidentally Detected Pericardial Defect in a Patient with Pneumothorax as Confirmed on Video-Assisted Thoracoscopic Surgery (흉강경 수술로 확인한 우연히 발견된 기흉을 동반한 심막결손)

  • Hyunwoo Cho;Eun-Ju Kang;Moon Sung Kim;Sangseok Jeong;Ki-Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.749-755
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    • 2021
  • Congenital defects of the pericardium, which are generally asymptomatic, are rare disorders characterized by complete or partial absence of the pericardium. Here, we report a rare case of a 19-year-old male who was incidentally diagnosed with congenital absence of the left pericardium during examination for symptoms of pneumothorax. Chest radiography and CT revealed a collapsed left lung without any evidence of trauma, no unusual findings of free air spaces along the right side of the ascending aorta, heart shifted toward the left side of the thorax, and a shallow chest. Subsequent thoracoscopy confirmed the absence of the left pericardium and displacement of the heart toward the left thoracic cavity. We further discuss the correlation between radiologic images and surgical findings of a congenital pericardial defect associated with spontaneous pneumothorax.

A Study on the Change of Image Quality According to the Change of Tube Voltage in Computed Tomography Pediatric Chest Examination (전산화단층촬영 소아 흉부검사에서 관전압의 변화에 따른 화질변화에 관한 연구)

  • Kim, Gu;Kim, Gyeong Rip;Sung, Soon Ki;Kwak, Jong Hyeok
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.503-508
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    • 2019
  • In short a binary value according to a change in the tube voltage by using one of VOLUME AXIAL MODE of scanning techniques of chest CT image quality evaluation in order to obtain high image and to present the appropriate tube voltage. CT instruments were GE Revolution (GE Healthcare, Wisconsin USA) model and Phantom used Pediatric Whole Body Phantom PBU-70. The test method was examined in Volume Axial mode using the pediatric protocol used in the Y university hospital of mass-produced material. The tube voltage was set to 70kvp, 80kvp, 100kvp, and mAs was set to smart mA-ODM. The mean SNR difference of the heart was $-4.53{\pm}0.26$ at 70 kvp, $-3.34{\pm}0.18$ at 80 kvp, $-1.87{\pm}0.15$ at 100 kvp, and SNR at 70 kvp was about -2.66 higher than 100 kvp and statistically significant (p<0.05) In the Lung SNR mean difference analysis, $-78.20{\pm}4.16$ at 70 kvp, $-79.10{\pm}4.39$ at 80 kvp, $-77.43{\pm}4.72$ at 100 kvp, and SNR at 70 kvp at about -0.77 higher than 100 kvp were statistically significant. (p<0.05). Lung CNR mean difference was $73.67{\pm}3.95$ at 70 kvp, $75.76{\pm}4.25$ at 80 kvp, $75.57{\pm}4.62$ at 100 kvp and 20.9 CNR at 80 kvp higher than 70 kvp and statistically significant (p<0.05) At 100 kvp of tube voltage, the SNR was close to 1 while maintaining the quality of the heart image when 70 kvp and 80 kvp were compared. However, there is no difference in SNR between 70 kvp and 80 kvp, and 70 kvp can be used to reduce the radiation dose. On the other and, CNR showed an approximate value of 1 at 70 kvp. There is no difference between 80 kvp and 100 kvp. Therefore, 80 kvp can reduce the radiation dose by pediatric chest CT. In addition, it is possible to perform a scan with a short scan time of 0.3 seconds in the volume axial mode test, which is useful for pediatric patients who need to move or relax.